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Newsletter Vol. 20, No. 10

New Jersey Medicaid·NJ·Provider Notice
Effective date
Jul 1, 2010
We identified it
Jun 20, 2026
Days to comply

Summary

HMS Government Services replaces Horizon Blue Cross/Blue Shield as the new pharmacy audit contractor for New Jersey Medicaid services effective July 1, 2010. Pharmacies must comply with new audit processes including desk audits, on-site audits, and a future AuditAvoid self-correction program starting January 2011.

Action Required

Action needed
By June 30, 2010: Pharmacy staff must respond to any outstanding audit requests from Horizon Blue Cross/Blue Shield. After July 1, 2010: Direct all audit-related questions to HMS Government Services at (800) 310-0865 and comply with their audit instructions. Prepare for new audit processes including potential participation in AuditAvoid program starting January 2011.